A new analysis finds that the healthcare field is a dominant fixture on the list of False Claims Act recoveries, tallying $2.5 billion in payouts to the feds — with two big-name skilled nursing operators leading the list.
Bloomberg Law crunched FCA payout numbers from a two-year period and found that about 90% of the government’s collections came from healthcare. Both Genesis Healthcare and Signature made the list of biggest payments for violating the act, which imposes liabilities on companies that defraud government programs such as Medicare and Medicaid.
“The Department of Justice has placed a high priority on rooting out and pursuing those who cheat government programs for their own gain,” Assistant Attorney General Jody Hunt said in December in announcing $2.8 billion in recoveries for 2018. “The recoveries announced today are a message that fraud and dishonesty will not be tolerated.”
Kennett Square, PA-based Genesis — the largest nursing home chain in the U.S. — agreed in June 2017 to pay more than $53 million to settle six lawsuits, the seventh highest payout on Bloomberg’s top 10 list. Among the claims resolved by the settlement were allegations that the company billed Medicare for hospice services for beneficiaries who were not terminally ill, and submitting claims for medically unnecessary therapy services, McKnight’s reported then. Genesis denied the allegations at the time.
Signature HealthCARE made the 10th spot on the list after the company agreed to pay $30 million last year. DOJ officials alleged that the Louisville-based operator routinely placed residents at higher therapy levels to increase claims. The settlement did not include an admission of wrongdoing and Signature at the time emphasized that “resident care remains our first priority.”
Dialysis provider DaVita Medical holdings topped the list with its $270 million settlement, announced in October. Most common reasons for landing in the DOJ’s crosshairs included billing for medically unnecessary services (80 instances), billing for services never rendered (48), kickbacks (40) and upcoding (32).
Experts urge skilled care providers to avoid such run-ins with the law by adopting and following strong fraud compliance programs, Bloomberg reported.